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​NHS Dentistry: 4 million fail to get care they need as access problems go England-wide

20 November 2019




New analysis from the BDA indicates access problems for NHS dental services are now blighting communities across every English region.


Analysis of the government’s last GP Survey indicates over 1.4 million adult patients have tried and failed to access care – with a further 2 million estimated to have not tried in the belief they would be unable to secure an appointment. With 130,000 reporting they are on waiting lists, and over 700,000 citing cost as a barrier, this brings a level of unmet need to over 4 million people, or nearly 1 in 10 of the adult population.

Areas facing challenges have not hitherto experienced significant problems, with many of the worst affected areas in parts of London and the South East, including the overwhelming majority of London boroughs, Brighton, and parts of Kent and Surrey. 

The government has acknowledged issues in a few ‘hotspot’ areas with a history of access problems – such as West Yorkshire, Cumbria and Cornwall. Data also indicates lower success rates among patients attempting to secure an appointment for the first time, the young, and ethnic minorities.

The BDA says these figures reflect the perfect storm facing patients, as budget cuts, contract failure and staffing problems bite. NHS dentistry is operating on a budget that has remained largely static since 2010, but with patients contributing a greater share each year through increasing NHS charges.

The current target-driven NHS contract funds care for little over half the population, and has prompted a collapse in morale within the workforce. Recruitment problems have become endemic, with BDA surveys indicating 75% of practices struggling to fill vacancies, and 59% of dentists stating their intentions to reduce or end NHS work. Problems are most severe among practices doing most NHS work.


The BDA has called on all parties to remove barriers to care, address historic underfunding and deliver meaningful reform of the discredited NHS contract system. It has welcomed Labour proposals to take ‘band 1’ treatments like examinations out of the charging system, but stressed any moves to improve access must be pursued in tandem with measures to support the workforce.

The deteriorating state of access has prompted Parliament’s Health and Social Care Committee to launch an enquiry. Recent closures and recruitment problems have left families in Portsmouth facing ferry rides, with patients in parts of Cornwall round trips of up to 120 miles to access care.

The BDA's Chair of General Dental Practice Dave Cottam said:

“Underfunding, failed contracts and recruitment problems are creating a perfect storm for patients.

“These access problems are no longer affecting a few ‘hotspots’, but are now the reality for millions across every English region.

“The public are entitled to access care, but the system is stacked against them. They face practices struggling to fill vacancies, NHS charges designed to discourage attendance, while our contracts cap patient numbers.


“Those losing out are the patients who need us most. The next government owes it to them to ensure this service has a future.”